The District of Columbia was an exception. Among the states that saw worsening numbers of children without insurance, South Dakota's rate was the most severe.

Georgetown researchers said these changes happened despite an improving economy and low overall unemployment. They shared possible reasons why no states have made progress. Ultimately, they laid the problem at the feet of President Donald Trump's administration. Their words and health care policies may have discouraged people from enrolling, the researchers argued.

"No state, however well-intentioned, was able to overcome these negative national currents that we saw in 2017," said Joan Alker, one of the Georgetown researchers who authored the study.

The percent of children without health insurance in South Carolina from 4.3 to 5.1 from 2016 to 2017, according to Georgetown and the United States Census Bureau.

The change is noteworthy given many years of steady improvements in the coverage of South Carolina's children. By comparison, nearly 10 percent of minors here lacked health insurance in 2010.

For instance, the Department of Health and Human Services rolled out a program in 2012 that automatically enrolled 65,000 children in its Medicaid program. Through that initiative, called "express lane eligibility," parents who sign up for welfare payments or food stamps automatically enroll their children in Medicaid. The program is still underway today, a spokeswoman said.

"We had been making really great strides with really being ahead of the nation on the child uninsured rate," said Sue Berkowitz, director of the South Carolina Appleseed Legal Justice Center. "We’ve gone in the wrong direction. I personally think it’s avoidable."

You're more likely to lack health insurance if you fall into one of these demographic groups.

The problem might be related to the worsening rate of adults without health insurance, Berkowitz said. And she advocated for what she called the clearest path to insuring more children: expanding Medicaid eligibility.

South Carolina is one of a dwindling number of states that has declined to expand Medicaid eligibility. Gov. Henry McMaster remains opposed to it, The Post and Courier reported.

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Bureaucratic red tape could be partly to blame for why states enrolled fewer children, Alker said, as well as constant news about the Affordable Care Act's repeal and immigration policies.

Alker likened the year to "yanking back the welcome mat" for families who could sign their children up for health insurance.

Both the percent of children covered by Medicaid and those covered by private insurance in South Carolina decreased, according to information from the Census Bureau. The state's own information is at odds with that. A spokeswoman for the Medicaid agency said they had recorded no drop in children enrolled.

For the country, Alker said it should be taken as a sign that no states have made progress, which she said was the most striking result of this year's report from Georgetown.